The stroke program at the Neurological Institute has provided clinical, research, and post-graduate opportunities in an eclectic style from its founding 1983. Over 50 trainees have had one or more years of such experiences, their number including both American and foreign clinicians. All but a handful now hold academic positions, many tenured, some are chaired professors, and at least 5 are now departmental chairs. SPOTRIAS provided qualitative and quantitative increases n opportunities for us. A more structured program could be put in place, one no longer controlled by the unpredictability in available funds for salary and planned committed time. The program now offers opportunities to take courses in epidemiology and clinical trial design at the Mailman School of Public Health, along with the time away from clinical duties to pursue them. The SPOTRIAS fellow also takes the lead in organizing and selecting the subjects and patients forthe weekly conferences, held midday on Fridays; joins or starts clinical research projects with one of more faculty, the success of which is reviewed twice yeariy with the SPOTRIAS faculty. The preparation and submission of abstracts for meetings are part of the responsibility, which is also reviewed by faculty. (S)he also participates in monthly SPOTRIAS meetings and in the collection of data and the analyses for publication. The range of cases is also reviewed monthly with a faculty supervisor to insure ample exposure to the disease states that comprise stroke. Weekly attendance in the Stroke Clinic adds to the experience.